Prioritizing the Neurosurgical Patients’ Care: Limited Resources and Successful Management in COVID-19 Pandemic

he novel Coronavirus (SARS-CoV-2) has spread worldwide, contributing to the COVID-19 pandemic [1]. Several reports regarding the spread of COVID-19 infection among the institutions during various neurosurgical procedures especially endoscopic endonasal surgery have been published to provide recommendations for the safety of health professionals and safe management of patients [2-4]. All outpatient neurosurgical activities need to be re-prioritized except for selected patients who need post-operative check-ups and suture removal [5]. The present medical treatment system needs to be remodeled by identifying main neurosurgical emergency hospitals, including acute traumatic and non-traumatic intracranial hemorrhage, symptomatic hydrocephalus, and tumors with elevated intracranial pressure, spinal cord compression with focal deficits, as well as traumatic cranial and spinal emergencies. One of the “main” hospitals can be chosen as the regional neuro-oncological center for management of all patients referred from other neurosurgical oncology departments. Also, a 24/7 on-call system can provide services for spine and cranial non-emergency treatment to patients. Although controversial, a COVID-19 swab can be routinely carried out for all patients who need emergency neurosurgical intervention or admission in an intensive care unit [6]. In patients needing urgent surgery who are COVID-19 positive or unable to participate in screening, the following precautions need to be followed: